Background: It has been questioned whether systematic transrectal ultrasound-guided biopsies (TRUS-gb) miss significant prostate cancers (PCa). MRI guided biopsies have been proposed for men where the initial TRUS-gb was normal and may increase sensitivity and detection of significant PCa, a definition based on the presence of a Gleason grade 4 or more in the biopsies. In 2010, Schröder et al. demonstrated with data from the ERSPC-study, that 0.03% of men with an initial, normal biopsy set died from PCa after 11 years of follow-up . Here, we calculate the risk of PCa specific mortality in men with an initial, benign biopsy set, in the complete nation-wide cohort of men who underwent evaluation for PCa with TRUS-gb during a 16-year period, in which systematic PSA screening or MRI was not part of the clinical setup.

Methods: Data originate from the Danish Prostate Cancer Register (DaPCaR). All men undergoing their first TRUS-gb...

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